Despite the Maharashtra government making transplantation of organs from cadaver patients mandatory under the Transplantation of Human Organs Act (TOHA) 1994, the state has been witnessing an acute shortage of donors, especially kidney donors. The State managed to authorize only about 24 kidney transplants in the past year for a total of 250 patients (225 from Mumbai and 25 from Pune) who are on the wait-list for a transplant.

The figures that were released by officials from the Zonal Transplant Coordination Centre (ZTCC) alarmed the government on the need for speeding up the authorization process especially since the patients were increasingly opting for other illegal modes of sourcing kidneys.

Revealing details on occasion of Maharashtra Organ Transplantation Day, officials from ZTCC said that due to the acute shortage and urgency in procuring organs, most of the patients were being lured into the 'Kidney Bazar' by several touts and middlemen, making Mumbai as their base for carrying out the highly illegal operation.

According to Dr Vatsala Trivedi, secretary, ZTCC, there are about 150 patients per million populations who suffer from kidney diseases at any given point of time. From these, hardly 25 per cent avail of any treatment and only a scanty 2.5 per cent opt for transplant, making it a difficult for the doctors to educate the patients on the need for availing a transplant. "Every year, close to 70,000 people die in accidents, even if 5 per cent of these turn out to be useful cadaver donors, it will help a great deal in tackling the shortage of the organs", says Dr Trivedi. "It has to be understood that one life could save 7-8 other lives as there are several organs that could be donated once the patient has been declared brain-dead", added Dr Trivedi.

According to Dr Trivedi, while the cadaver transplants are carried out with the consent of the patient's relatives, it is done only after a team of specialists certifies the donor patient is brain-dead. However, cadaver donation has been hit by factors like low awareness amongst the general public, medical fraternity and lack of a co-ordinated effort in hospitals, noted Dr Trivedi. For instance, last year 24 cadaver transplants were performed in Mumbai. This is apart from the approximately 30 live donor transplants approved by the State Authorization Committee every month.

"Brain death itself is a new concept, which our generation of doctors had to learn recently. Explaining this concept to the patient's relatives is another difficult task that the doctors have to encounter," Shrugged Dr. Trivedi.

It is upto the government to take up initiatives and encourage patients and relatives to opt for transplants, given the many positive effects it possess. For one, the government should felicitate relatives of the brain dead donors so that the practice is encouraged, there is need for more data to be published on the facts concerning transplants, need to form more support groups and involving the media to communicate the message among the masses, urged Dr Trivedi.